A long-term follow-up study of adolescent psychiatric in-patients. Part III. Predictors of disability

A total of 1095 adolescent psychiatric in-patients were followed up 15-33 y ears after hospitalization by record linkage to the National Register of Di sability Benefits. On the basis of hospital records, all patients were redi agnosed according to DSM-IV and scored on data postulated to have predictiv e power with regard to disability. The factors were investigated by Kaplan- Meyer survival analysis and Cox regression. A psychotic or organic disorder , low score on DSM-IV Axis V (GAF) and the use of psychotropic medication a t hospitalization were among the strong predictors of later disability, as were low IQ, poor achievement at school, somatic disorders, and self-harmin g behaviour (all P < 0.01). Cox analysis showed that, of these, the followi ng factors remained strong and independent predictors of disability: psycho tic and organic disorders (relative risk (RR) = 3.1, 95% confidence Interva l (CI) = 2.4-4.0), IQ < 90 (RR = 1.8, CI = 1.5-2.3); and GAF < 30 (RR = 1.9 , CI = 1.5-2.4). Former adolescent psychiatric in-patients with a psychotic or organic disorder had a very high risk of later disability (71-81%), whe reas those with other psychiatric diagnoses, and with IQ greater than or eq ual to 90 and GAF greater than or equal to 30 at hospitalization, had a rel atively low risk of disability (22-29%).